| Abdomen 1 View (74018) |
$343 |
$490 |
3.7× |
| Abdomen 2 views (74019) |
$357 |
$510 |
3.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$2,240 |
$3,200 |
5.3× |
| Angiography extremity bilateral rs&i (75716) |
$12,180 |
$17,400 |
3.7× |
| Angiography extremity unilateral rs&i (75710) |
$12,670 |
$18,100 |
3.8× |
| Ankle 2 views (73600) |
$245 |
$350 |
2.7× |
| Aortography thoracic serialography rs&i (75605) |
$3,570 |
$5,100 |
0.6× |
| Artery X-Rays Abdomen (75726) |
$3,150 |
$4,500 |
0.5× |
| Artery X-Rays Pelvis (75736) |
$12,600 |
$18,000 |
2.1× |
| Arthrogram hip (73525) |
$1,050 |
$1,500 |
2.9× |
| Arthrogram Wrist (73115) |
$623 |
$890 |
1.7× |
| Bone age studies (77072) |
$420 |
$600 |
3.8× |
| Bone Imaging 3 Phase (78315) |
$1,190 |
$1,700 |
2.8× |
| Bone Imaging Limited Area (78300) |
$1,400 |
$2,000 |
3.3× |
| Bone Imaging Multiple Areas (78305) |
$1,960 |
$2,800 |
4.6× |
| Bone Imaging Whole Body (78306) |
$1,120 |
$1,600 |
2.7× |
| Bone survey infant (77076) |
$1,050 |
$1,500 |
9.5× |
| Brain Flow Imaging Only (78610) |
$2,310 |
$3,300 |
4.0× |
| Brain Image W/Flow < 4 Views (78601) |
$2,310 |
$3,300 |
5.5× |
| Brain imaging < 4 static views (78600) |
$2,310 |
$3,300 |
5.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$3,010 |
$4,300 |
5.3× |
| Brain Imaging Minimum 4 Static Views (78605) |
$2,310 |
$3,300 |
4.0× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$2,590 |
$3,700 |
6.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,710 |
$5,300 |
10.1× |
| Cat Scan Follow-Up Study (76380) |
$1,540 |
$2,200 |
16.8× |
| Cerebrospinal Fluid Scan (78630) |
$3,010 |
$4,300 |
5.3× |
| Chest 1 view (71045) |
$287 |
$410 |
3.1× |
| Chest 2 views (71046) |
$357 |
$510 |
3.9× |
| Chest 3 views (71047) |
$420 |
$600 |
4.6× |
| Chest 4 or more views (71048) |
$840 |
$1,200 |
7.6× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$770 |
$1,100 |
7.0× |
| Clavicle complete (73000) |
$658 |
$940 |
7.2× |
| Contrast Exam Abdominl Aorta (75625) |
$11,760 |
$16,800 |
3.5× |
| Contrast X-Ray Bladder (74430) |
$1,120 |
$1,600 |
3.0× |
| Contrast X-Ray Of Elbow (73085) |
$1,330 |
$1,900 |
3.6× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,330 |
$1,900 |
3.6× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$371 |
$530 |
2.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,292.50 |
$3,275 |
6.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,820 |
$2,600 |
7.2× |
| CT abdomen w contrast (74160) |
$1,750 |
$2,500 |
9.5× |
| CT abdomen w wo contrast (74170) |
$1,960 |
$2,800 |
10.6× |
| CT abdomen w/o contrast (74150) |
$1,540 |
$2,200 |
14.0× |
| CT Angio Abdomen and Pelvis (74174) |
$1,960 |
$2,800 |
5.3× |
| CT Angio Chest (71275) |
$1,960 |
$2,800 |
10.6× |
| CT Angio Head (70496) |
$1,960 |
$2,800 |
10.6× |
| CT angio hrt w/3d image (75574) |
$2,030 |
$2,900 |
5.5× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,170 |
$3,100 |
11.7× |
| CT Angio Neck (70498) |
$2,030 |
$2,900 |
11.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,890 |
$2,700 |
10.2× |
| CT cervical spine w/ contrast (72126) |
$2,450 |
$3,500 |
6.7× |
| CT cervical spine w/o contrast (72125) |
$1,400 |
$2,000 |
12.7× |
| CT cervical spine w/wo cont (72127) |
$2,660 |
$3,800 |
14.4× |
| CT chest w contrast (71260) |
$1,750 |
$2,500 |
9.5× |
| CT chest w/wo contrast (71270) |
$1,960 |
$2,800 |
10.6× |
| CT head/brain with contrast (70460) |
$1,750 |
$2,500 |
9.5× |
| CT head/brain without and with contrast (70470) |
$1,960 |
$2,800 |
10.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,030 |
$2,900 |
5.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$329 |
$470 |
3.6× |
| CT hrt w/3d image congen (75573) |
$2,030 |
$2,900 |
5.5× |
| CT iac w contrast (70481) |
$1,750 |
$2,500 |
9.5× |
| CT lower ext w/o (73700) |
$1,540 |
$2,200 |
14.0× |
| CT lower extremity w/contrast material (73701) |
$2,380 |
$3,400 |
12.9× |
| CT lumbar spine w contrast (72132) |
$1,750 |
$2,500 |
4.8× |
| CT lumbar spine w/o contrast (72131) |
$1,120 |
$1,600 |
10.2× |
| CT maxillofacial w contrast (70487) |
$1,750 |
$2,500 |
9.5× |
| CT maxillofacial wo contrast (70486) |
$1,540 |
$2,200 |
14.0× |
| CT neck tissue combo (70492) |
$1,960 |
$2,800 |
10.6× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,960 |
$2,800 |
10.6× |
| CT orbits w/o contrast (70480) |
$1,540 |
$2,200 |
14.0× |
| CT pelvis w&w/o contrast (72194) |
$2,100 |
$3,000 |
11.3× |
| CT pelvis w/o contrast (72192) |
$1,540 |
$2,200 |
14.0× |
| CT scan of leg combo (73702) |
$2,590 |
$3,700 |
14.0× |
| CT scans face/jaw combo (70488) |
$2,030 |
$2,900 |
11.0× |
| CT soft tissue neck w contrast (70491) |
$1,750 |
$2,500 |
9.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,540 |
$2,200 |
14.0× |
| CT thoracic spine w contrast (72129) |
$1,750 |
$2,500 |
9.5× |
| CT thoracic spine w/o contrast (72128) |
$1,750 |
$2,500 |
15.9× |
| CT thorax w/o contrast (71250) |
$1,190 |
$1,700 |
10.8× |
| CT unlisted procedure (76497) |
$980 |
$1,400 |
10.7× |
| CT upper ext wo (73200) |
$2,100 |
$3,000 |
19.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,660 |
$3,800 |
14.4× |
| CT upper extremity with contrast (73201) |
$2,380 |
$3,400 |
6.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,660 |
$3,800 |
14.4× |
| Cta Abdomen (74175) |
$2,310 |
$3,300 |
12.5× |
| CTA pelvis (72191) |
$2,590 |
$3,700 |
14.0× |
| Diskography lumbar (72295) |
$2,170 |
$3,100 |
1.1× |
| Dxa bone density study (77085) |
$175 |
$250 |
1.6× |
| Echo Guide For Artery Repair (76936) |
$840 |
$1,200 |
3.7× |
| Esophagram (74220) |
$511 |
$730 |
2.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$567 |
$810 |
5.1× |
| Fluoroscopy up to 1 hr (76000) |
$770 |
$1,100 |
3.1× |
| Follow-Up Angiography (75898) |
$1,400 |
$2,000 |
0.4× |
| Foot 2 views (73620) |
$210 |
$300 |
2.3× |
| Forearm 2 views (73090) |
$273 |
$390 |
3.0× |
| Gastric emptying imaging study (78264) |
$980 |
$1,400 |
2.3× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$525 |
$750 |
1.2× |
| Gated Heart Planar Single (78472) |
$1,890 |
$2,700 |
4.5× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$693 |
$990 |
1.2× |
| Hand 2 views (73120) |
$238 |
$340 |
2.2× |
| Heart first pass single,planar (78481) |
$1,960 |
$2,800 |
3.4× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$6,160 |
$8,800 |
1.8× |
| Hepatobil Syst Image W/Drug (78227) |
$1,610 |
$2,300 |
2.8× |
| Hepatobiliary System Imaging (78226) |
$1,260 |
$1,800 |
3.0× |
| Ht Muscle Image Spect Sing (78451) |
$5,250 |
$7,500 |
3.8× |
| Hysterosalpingogram (74740) |
$1,540 |
$2,200 |
6.1× |
| Infusion Ivp (74410) |
$1,820 |
$2,600 |
9.8× |
| Joint Survey Single View (77077) |
$238 |
$340 |
2.2× |
| K Flow/Funct Image Multiple (78709) |
$1,820 |
$2,600 |
3.2× |
| K Flow/Funct Image W/Drug (78708) |
$1,680 |
$2,400 |
2.9× |
| K Flow/Funct Image W/O Drug (78707) |
$1,820 |
$2,600 |
3.2× |
| Kidney Imaging Morphol (78700) |
$1,750 |
$2,500 |
4.1× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,610 |
$2,300 |
3.8× |
| Knee 3 Views (73562) |
$280 |
$400 |
3.0× |
| Liver & Spleen Imaging Static Only (78215) |
$1,890 |
$2,700 |
4.5× |
| Liver imaging w/vascular flow (78202) |
$1,190 |
$1,700 |
2.1× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,890 |
$2,700 |
3.3× |
| Lung perfusion differential (78597) |
$1,890 |
$2,700 |
4.5× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,400 |
$2,000 |
2.4× |
| Lung Ventilation Imaging (78579) |
$1,820 |
$2,600 |
4.3× |
| Lymph System Imaging (78195) |
$1,540 |
$2,200 |
2.7× |
| Magnetic Image Jaw Joint (70336) |
$3,220 |
$4,600 |
12.8× |
| Meckels Divert Exam (78290) |
$1,820 |
$2,600 |
4.3× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,940 |
$4,200 |
8.0× |
| MRA head w/o contrast (70544) |
$1,855 |
$2,650 |
7.4× |
| MRA head with contrast (70545) |
$2,730 |
$3,900 |
7.4× |
| MRA neck w contrast (70548) |
$2,380 |
$3,400 |
6.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,723 |
$3,890 |
7.4× |
| MRA neck w/o contrast (70547) |
$1,981 |
$2,830 |
7.9× |
| MRI abdomen w/o contrast (74181) |
$1,872.50 |
$2,675 |
7.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,240 |
$3,200 |
2.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,660 |
$3,800 |
7.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,065 |
$2,950 |
2.5× |
| MRI bone marrow blood supply (77084) |
$3,710 |
$5,300 |
14.7× |
| MRI cardiac w/o contrast (75557) |
$3,710 |
$5,300 |
14.7× |
| MRI cervical spine w contrast (72142) |
$2,730 |
$3,900 |
7.4× |
| MRI cervical spine w/o cont (72141) |
$1,592.50 |
$2,275 |
6.3× |
| MRI chest w/o contrast (71550) |
$1,638 |
$2,340 |
6.5× |
| MRI chest with contrast (71551) |
$2,590 |
$3,700 |
3.1× |
| MRI chest wo w contrast (71552) |
$2,201.50 |
$3,145 |
6.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,576 |
$3,680 |
7.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,737 |
$3,910 |
7.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,925 |
$2,750 |
7.6× |
| MRI lumbar spine w contrast (72149) |
$2,240 |
$3,200 |
6.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,485 |
$3,550 |
6.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,467.50 |
$3,525 |
9.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,667 |
$3,810 |
7.2× |
| MRI pelvis w contrast (72196) |
$2,730 |
$3,900 |
7.4× |
| MRI pelvis w/o & w contrast (72197) |
$2,187.50 |
$3,125 |
5.9× |
| MRI pelvis w/o contrast (72195) |
$1,638 |
$2,340 |
6.5× |
| MRI thoracic spine w/o contrast (72146) |
$2,187.50 |
$3,125 |
8.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,590 |
$3,700 |
7.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,855 |
$2,650 |
7.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,467.50 |
$3,525 |
6.7× |
| MRI, abdomen, combo (74183) |
$2,205 |
$3,150 |
6.0× |
| MRI, dorsal spine combo (72157) |
$2,467.50 |
$3,525 |
6.7× |
| MRI, dorsal spine contrast (72147) |
$2,730 |
$3,900 |
7.4× |
| MRI, joint upper extrem (73221) |
$1,872.50 |
$2,675 |
7.4× |
| MRI, joint upper extrem combo (73223) |
$2,467.50 |
$3,525 |
6.7× |
| MRI, lumbar spine combo (72158) |
$2,485 |
$3,550 |
6.7× |
| Myelogram cervical (72240) |
$1,960 |
$2,800 |
2.4× |
| Myelogram Lumbar (72265) |
$3,430 |
$4,900 |
4.1× |
| Myelography thoracic (72255) |
$3,080 |
$4,400 |
3.7× |
| Myelograpy 2/more regions rs&i (72270) |
$2,380 |
$3,400 |
2.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$5,110 |
$7,300 |
3.7× |
| Myocardial Spect Multiple Studies (78452) |
$3,010 |
$4,300 |
2.2× |
| Neck soft tissue (70360) |
$252 |
$360 |
2.7× |
| Nm csf leak detection (78650) |
$1,400 |
$2,000 |
1.0× |
| Nm unlisted gi procedure (78299) |
$910 |
$1,300 |
2.2× |
| Optic foramina (70190) |
$574 |
$820 |
6.2× |
| Parathyroid Planar Imaging (78070) |
$910 |
$1,300 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$294 |
$420 |
2.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,450 |
$3,500 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,190 |
$1,700 |
2.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$525 |
$750 |
4.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,680 |
$2,400 |
2.9× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$308 |
$440 |
3.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$294 |
$420 |
3.2× |
| Radex elbow complete minimum 3 views (73080) |
$280 |
$400 |
3.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$518 |
$740 |
4.7× |
| Radex fingr minimum 2 views (73140) |
$231 |
$330 |
2.5× |
| Radex foot complete minimum 3 views (73630) |
$238 |
$340 |
2.6× |
| Radex Hand Minimum 3 Views (73130) |
$273 |
$390 |
3.0× |
| Radex lower extremity infant minimum 2 views (73592) |
$245 |
$350 |
2.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$448 |
$640 |
4.9× |
| Radex Ribs Unilateral 2 Views (71100) |
$252 |
$360 |
2.7× |
| Radex shoulder complete minimum 2 views (73030) |
$357 |
$510 |
3.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$462 |
$660 |
5.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$1,540 |
$2,200 |
8.3× |
| Radex Spine 1 View Specify Level (72020) |
$420 |
$600 |
4.6× |
| Radex Sternum Minimum 2 Views (71120) |
$511 |
$730 |
5.6× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$413 |
$590 |
4.5× |
| Radex Toe Minimum 2 Views (73660) |
$259 |
$370 |
2.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$168 |
$240 |
1.5× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$259 |
$370 |
2.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$350 |
$500 |
3.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$1,330 |
$1,900 |
12.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$840 |
$1,200 |
7.6× |
| Radiologic exam colon double contrast study (74280) |
$1,260 |
$1,800 |
6.8× |
| Radiologic exam colon single contrast study (74270) |
$1,400 |
$2,000 |
7.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$336 |
$480 |
1.8× |
| Radiologic exam knee complete 4/more views (73564) |
$336 |
$480 |
3.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$476 |
$680 |
4.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$840 |
$1,200 |
4.5× |
| Radiologic exam swallow function contrast study (74230) |
$616 |
$880 |
3.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$518 |
$740 |
2.8× |
| Radiologic examination femur 1 view (73551) |
$126 |
$180 |
1.4× |
| Radiologic examination femur minimum 2 views (73552) |
$161 |
$230 |
1.8× |
| Radiologic examination knee 1/2 views (73560) |
$252 |
$360 |
2.7× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$602 |
$860 |
6.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$350 |
$500 |
3.8× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$980 |
$1,400 |
1.7× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,890 |
$2,700 |
4.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,470 |
$2,100 |
3.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,430 |
$4,900 |
6.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,520 |
$3,600 |
4.4× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,680 |
$2,400 |
2.9× |
| Scapula (73010) |
$511 |
$730 |
4.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$91 |
$130 |
3.9× |
| Shoulder 1 view (73020) |
$315 |
$450 |
3.4× |
| Shoulder Arthrography (73040) |
$1,400 |
$2,000 |
3.8× |
| Sialogram (70390) |
$602 |
$860 |
2.4× |
| Skull less than 4 views (70250) |
$511 |
$730 |
4.6× |
| Sternoclavicular joints (71130) |
$504 |
$720 |
5.5× |
| Thoracic spine 2 views (72070) |
$336 |
$480 |
3.0× |
| Thoracic spine 3 views (72072) |
$287 |
$410 |
2.6× |
| Thoracolumbar 2 views (72080) |
$399 |
$570 |
4.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$378 |
$540 |
0.9× |
| Thyroid Uptake Measurement (78012) |
$700 |
$1,000 |
1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$553 |
$790 |
1.3× |
| Ultrasound Breast Limited (76642) |
$280 |
$400 |
3.0× |
| Ultrasound Exam Aaa Screen (76706) |
$280 |
$400 |
2.5× |
| Ultrasound, abdomen limited (76705) |
$483 |
$690 |
4.4× |
| Unlisted magnetic resonance procedure (76498) |
$2,100 |
$3,000 |
22.9× |
| Upper gi w/o kub (74240) |
$476 |
$680 |
2.6× |
| Urethrocystogram voiding (74455) |
$1,680 |
$2,400 |
6.7× |
| Urethrocystography retrograde (74450) |
$1,050 |
$1,500 |
4.2× |
| Us breast unilateral complete (76641) |
$350 |
$500 |
3.2× |
| Us chest (76604) |
$840 |
$1,200 |
7.6× |
| Us complete joint (76881) |
$581 |
$830 |
5.3× |
| Us exam, pelvic, limited (76857) |
$455 |
$650 |
4.1× |
| Us head (76506) |
$840 |
$1,200 |
7.6× |
| Us kidney transplant (76776) |
$546 |
$780 |
4.9× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$336 |
$480 |
3.0× |
| Us ob detailed single fetus (76811) |
$1,750 |
$2,500 |
6.9× |
| Us ob limited 1 or more fetuses (76815) |
$770 |
$1,100 |
7.0× |
| Us ob transvaginal (76817) |
$770 |
$1,100 |
7.0× |
| Us pelvic non ob complete (76856) |
$609 |
$870 |
5.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$910 |
$1,300 |
8.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$364 |
$520 |
3.3× |
| Us retroperitoneal complete (76770) |
$623 |
$890 |
5.6× |
| Us retroperitoneal limited (76775) |
$406 |
$580 |
3.7× |
| Us scrotum and contents (76870) |
$609 |
$870 |
5.5× |
| Us spinal canal and contents (76800) |
$1,120 |
$1,600 |
10.2× |
| Us thyroid (76536) |
$644 |
$920 |
5.8× |
| Us transrectal (76872) |
$1,190 |
$1,700 |
10.8× |
| Vein X-Ray Chest (75827) |
$4,410 |
$6,300 |
2.7× |
| Venography caval inferior serialography rs&i (75825) |
$2,870 |
$4,100 |
0.9× |
| Venography extremity bilateral rs&i (75822) |
$1,890 |
$2,700 |
1.1× |
| Venography extremity unilateral rs&i (75820) |
$1,610 |
$2,300 |
1.0× |
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure |
$2,450 |
$3,500 |
0.4× |
| Vertebral fracture assessment via dxa (77086) |
$112 |
$160 |
1.2× |
| Wrist 2 views (73100) |
$210 |
$300 |
2.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$462 |
$660 |
5.0× |
| X-Ray Aorta Leg Arteries (75630) |
$11,340 |
$16,200 |
3.4× |
| X-Ray Bend Only L-S Spine (72120) |
$588 |
$840 |
5.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$238 |
$340 |
2.6× |
| X-Ray Exam Breast Specimen (76098) |
$280 |
$400 |
0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$126 |
$180 |
1.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$182 |
$260 |
1.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$350 |
$500 |
3.2× |
| X-Ray Exam Hip Uni 1 View (73501) |
$140 |
$200 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$161 |
$230 |
1.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$182 |
$260 |
1.6× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$245 |
$350 |
2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$196 |
$280 |
1.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$350 |
$500 |
3.2× |
| X-Ray Exam L-S Spine Bending (72114) |
$770 |
$1,100 |
7.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$490 |
$700 |
5.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$658 |
$940 |
6.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$294 |
$420 |
2.7× |
| X-ray eye for foreign body (70030) |
$185.50 |
$265 |
2.0× |
| X-ray humerus (73060) |
$308 |
$440 |
3.4× |
| X-ray IV pyelogram+tomography (74415) |
$2,170 |
$3,100 |
11.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$609 |
$870 |
6.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$238 |
$340 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$287 |
$410 |
2.6× |
| X-ray nose-rectum child f.b. (76010) |
$226.80 |
$324 |
2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$770 |
$1,100 |
7.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$469 |
$670 |
4.3× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$210 |
$300 |
1.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$336 |
$480 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$595 |
$850 |
6.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$693 |
$990 |
6.3× |
| X-ray thoracic spine 4 vw (72074) |
$840 |
$1,200 |
7.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,610 |
$2,300 |
4.4× |
| X-Rays Bone Length Studies (77073) |
$336 |
$480 |
3.0× |
| X-Rays Bone Survey Complete (77075) |
$1,190 |
$1,700 |
10.8× |
| Xr c-spine 4 or 5 views (72050) |
$455 |
$650 |
4.1× |
| Xr facial bones less than 3 views (70140) |
$224 |
$320 |
2.4× |
| Xr orbits complete 4 views (70200) |
$1,190 |
$1,700 |
10.8× |